Ice compressibility

A sprained ankle is the most frequent injury. The recommended treatment for a simple sprain is usually rest, ice, compression, and elevation (RICE). If a ligament is tom, however, surgery may be required to repair the injury. 

A contusion is an injury to soft tissue in which the skin is not penetrated, but swelling of broken blood vessels causes a bmise. The bmise is caused by a blow of excessive force to muscle, tendon, or ligament tissue. A bmise, also known as a hematoma, is caused when blood coagulates around the injury causing swelling and discoloring skin. Most contusions are mild and respond well to rest, ice, compression, and elevation of the injured area. 

Educate the patient on nonpharmacologic therapy, including each of the steps in RICE (rest, ice, compression, and elevation). If injury is the source of the pain and it occurred more than 48 hours ago, consider heat instead of ice. 

If the eyes have come into contact with COF, they should be flushed with water for at least 15 min. Ice compresses may also be used to help relieve the irritation. Pain relief may be provided using 2-3 drops of 0.5 % tetracaine [253,254,255,277]. 

If an injury is minor, the RICE (rest, ice, compression and elevation) method to... 

Local reactions to extravasation of mechlorethamine into the subcutaneous tissue result in a severe, brawny, tender induration that may persist for a long time. If the local reaction is unusually severe, a slough may result. If it is obvious that extravasation has occurred, the involved area should be promptly infiltrated with a sterile isotonic solution of sodium thiosulfate (167 mM) an ice compress then should be applied intermittently for 6 to 12 hours. Thiosulfate reacts avidly with nitrogen mustard and thereby protects tissue constituents. 

Since relatively small, briquetted, almond or pillow-shaped ice can be easily poured and metered, it became a superior cold-packing material. Roller presses were preferred for this operation because the thermal contraction of machine parts does not cause operational problems. Dry ice, compressed and shaped solid COj, is an even better material for cold packing because it evaporates rather than melts and its cooling capacity is almost three-times higher than that of water ice. Dry ice compacts are typically made with hydraulic presses and are still used today. 

Mechlorethamine is the only aliphatic nitrogen mustard currently on the U.S. market (Fig. 42.3). Its use is limited by extremely high reactivity, which leads to rapid and nonspecific alkylation of cellular nucleophiles and excessive toxicity. It is a severe vesicant, and if accidental skin contact occurs, the drug must be inactivated with 2% sodium thiosulfate (Na2S203) solution. This reagent reacts with the mustard to create an inactive, highly ionized, and water-soluble thiosulfate ester that can be washed away (Fig. 42.4). The affected tissue also should be treated with an ice compress for 6 to 12 hours. 

For larger bums or bums involving the finger tips and nail beds, the affected part should be placed in an iced Zephiran (1 750) or Hyamine 1622 (1 1500) bath for 4 hours. If a bath cannot be used, iced compresses with one of these agents should be used, changing the compress every 2 minutes. Solutions of Zephiran or Hyamine 1622 should not be used on the face. 

Systematic studies [8, 9] revealed that heating compensates for the effect of compression on the structure phase transition and dipole moment of ice. Compression lengthens the H-O bond, but heating shortens it. The dipole moment increases from 2.4 at 2,800 K to 3.0 Debye at 300 K and increases with density. Figure 40.3 shows the joint effect of pressure and temperature on the stability of ice VII, VIII, and X phases. The path integral MD calculations [9] agree well with measurements using infrared and Raman spectroscopy. 

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